Join our Waitlist

Child's Full Name

Child's Age and Date of Birth

Parent/Guardian Full Name

Email

Phone number

Tell us about your child

Does your child have a diagnosis of Autism?

Yes

No

Not Sure

Thanks for registering. We will contact you as soon as an opening becomes available.

Waitlist and Registration: Contact

(226) 647-2507

9 Willow St. Waterloo Ontario

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